J Vollmann1, I Knöchel-Schiffer. 1. Lehrstuhl für Sozialmedizin, Sozialpsychiatrie und Medizinethik an der Evangelischen Fachhochschule Berlin. vollmann@ukbf.fu-berlin.de
Abstract
DEFINITIONS: In the United States advance directives were developed since the late 60s in order to improve patients' medical decision making in case of incompetence in the future. In Germany 3 types of advance directives exist: 1. "Patientenverfügungen". 2. "Berreuungsverfügugen" and 3. "Vorsorgevollmachten". EMPIRICAL STUDIES: In empirical studies, mostly from the US, the implementation of advance directives into clinical practice and the attitude of physicians, patients, relatives and the general population have been examined. This review article provides results of theses studies in text and tables. CONCLUSION: Against the will of patients and of the general population advance directives are not often used in clinical practice. Physicians talk with patients about treatment procedures more often than they talk about end of life decisions. Informing patients about advance directives opens the chance to improve palliative care and respects their choices and values at the end of their lives.
DEFINITIONS: In the United States advance directives were developed since the late 60s in order to improve patients' medical decision making in case of incompetence in the future. In Germany 3 types of advance directives exist: 1. "Patientenverfügungen". 2. "Berreuungsverfügugen" and 3. "Vorsorgevollmachten". EMPIRICAL STUDIES: In empirical studies, mostly from the US, the implementation of advance directives into clinical practice and the attitude of physicians, patients, relatives and the general population have been examined. This review article provides results of theses studies in text and tables. CONCLUSION: Against the will of patients and of the general population advance directives are not often used in clinical practice. Physicians talk with patients about treatment procedures more often than they talk about end of life decisions. Informing patients about advance directives opens the chance to improve palliative care and respects their choices and values at the end of their lives.
Authors: J M Teno; J Lynn; R S Phillips; D Murphy; S J Youngner; P Bellamy; A F Connors; N A Desbiens; W Fulkerson; W A Knaus Journal: J Clin Ethics Date: 1994